20191138 Ver 1_Shoreline Stabilization_20190826

State of North Carolina
Department of Environment and Natural Resources
r Division of Water Resources®
Water Resources 15A NCAC 02H .0500 —Water Quality Certification, Shoreline Stabilization.
ENVIRONMENTAL QUALITY FORM: SSGP 02-2017
Shoreline Stabilization Application Form 2 1 9 1 1 3 8
Three copies of the application (including attachments) and the application fee should be sent to:
If sending via US Postal Service If sending via delivery service (UPS, FedEx, etc.)
Karen Higgins Karen Higgins
DWR — 401 & Buffer Permitting Branch DWR — 401 & Buffer Permitting Branch
1617 Mail Service Center 512 N. Salisbury Street
Raleigh, NC 27699-1617 Raleigh, NC 27604
A. Applicant Information [15A NCAC 02H .0502(a)]
1. Owner Information
Name: ('5' l enn V1 an
Mailing Address: —R �)nblo- �h _ane -
r N l
Telephone Number: 2V- Z07- (W74' Fax Number: 1
E-mail Address: a� \JY10LY) aQ C.0r+1Z-73CnW V Cnn
2. Agent/ Contact Person Information
A signed and dated copy of the Agent Authorization letter must be attached if the Agent has
signed this application form. (A form can be downloaded here:
http://www saw usace army mil/Portals/59/docs/regulatory/regdocs/Permits/SAMPLE AGENT AUTHORIZ
ATION FORM. df)
Name: Y
Company Affiliation: yl r' �f'lCr.
Mailing Address: l V 1f' b
fir' o0 �-ryl Gun , N C- Z (.0 (D
Telephone Number:,�,R-(Cho Fax Number: %/o4-526-3400
E-mail Address:
B. Project Information f15A NCAC 02H .0502(a) & (b)]
1. Attach a vicinity map (i.e. street map) clearly showing the location of the property with
respect to local landmarks such as towns, rivers, and roads.
2. Provide a detailed site plan showing property boundaries and proposed locations of
vegetation clearing, buildings, retaining walls, docks, impervious surfaces, rip rap, excavation
or dredging below Full Pond/ Normal Water Level elevations, and construction access
corridors. You may use the diagram provided at the end of this application form.
FORM: SSGP 02-2017 Page 1 of 3

3. Attach a photograph of the shoreline/ buffer proposed to be stabilized. (Include a scale of
some sort- a yard stick, shovel handle, etc.)
4. Location of the property (where work is to be conducted)
County: I r'edel I Nearest Town: I pMreSV i lle.
Lake/ river/ ocean adjacent to property: 1Vorman
Property size (acres): I . _,*7)a Ages
Subdivision name or site address (include phase/lot number): Rl + LD+ 7210
'73 T�ehobaf h Lan e My� e5y'1) le N C 2A 11-7
Directions to site -please include road names and numbers, landmarks, etc.:Vrel••115R 6dt36
an AU ICU= ". Lrtr
de (in decimal degrees)
l h Ln. i%b H is'mu l•de• ac. b n to f i-.
Longitude decimal degrees)-' Q 7
5. Describe the existing land use or condition of the site at the time of this application
(residential, undeveloped, etc.): 18e1 y)-ha.I
6. Describe proposed work (include discussion as to how hardening of shoreline has been
avoided, or why it is necessary):" tA-eeN%awrmAW�12�5�'1ere�int•W 01iCD�ecL,
Im
lar►A- 14 �t n rhes cxoyj Q o f Shoreli n e no e hq t res Cts .
7. Will work be conducted from land? ff v From water? Rr V
8. Total amount of impacts below the normal pool lake level / Normal Water Level
Permanent impacts (including all excavation, backfill, rip rap, retaining walls, etc.) in square feet:
4(ln I -C x ISP+ = M00 _s -P. rio,rna /ala Qe1cl vipi
Temporary impacts in square feet:
9. Total amount of impacts above the normal pool lake level/ Normal Water Level and 50 feet
land -ward
Permanent impacts (including back filLl, excavation, rip rap, retaining walls tc.) in square feet:
emporary impacts temporary clearing, construction corridor) in square feet:
10. Please describe the vegetation above the normal pool lake level/Normal Water Level and 50
et landward to be impacted (number of trees, for instance):
11. SignatB
a4l-ZC)-l9
Owner/Agent's Signature* r1a NCAC 02H .0502(f)l Date
-Agent's signature is valid only if an authorization letter from the owner is provided.
FORM: SSGP 02-2017 Page 2 of 4

12. Please approximately sketch the following information on this plan and provide dimensions for
each item:
a. All proposed vegetation clearing
b. Location of rip rap or fill to be placed above the Full Pond/ Normal Water Level elevation
c. Location of rip rap or fill to be placed below the Full Pond/ Normal Water Level elevation
d. Location of any proposed structures such as buildings, retaining walls, docks, etc.
e. Location of any excavation or dredging below the Full Pond/ Normal Water Level elevation
Full Pond/ Normal Water
Shoreline
�No
Plan View
FORM: SSGP 02-2017
Lake
(At Full Pond/ Normal Water Level)
.,a
AV
Lake
Int Fug paid/ Nnimal Water Le Q Existing Dock
3oftX7ft
3ftXL%ft
each wfdl pad/ NWL
Full Pond/ Normal Water Level as,
e— -- 4ftx 150 ft
_ �f10 reTne Riprap nype roll pond/ NWL
7 ft.X 1508
additional clearing
' It nese—ry
E AMPLE
Plan View
Page 3 of 4

M,U
La ke
(At Full Pond/ Normal Water Level)
Side View
LL-
10 ft. bank
height
Side Vi
Sed
-rre r-��6JaA CSF°
3 ft. below full pond water level 4 ft. above full pond water level 2 ft. additional clearing
'if necessary
Existing bank
FORM: SSGP 02-2017 Page 4 of 4

6/26/2019
OCONNECTGIS
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Printed June 26, 2019
See Below for Disclaimer
Addresses
• Infrastructl.re
' h onResidetrtial Use
' Residential Use
Streets
Interstate
Ramp
— US Hay
State Hv y
— Nlain Road
Local Road
Pesidential
Pri,ate
Inactive
Parcels Hooks
Parcels
r�
Parcel Vailirg Address
Cita+ Limits
Lake Normar
Iredell COLr`ylire
1: 131 Feet
3
The maps prepared for this website are generated from recorded deeds, plats, and other public records. Users of these maps are hereby notified that the information
provided herein should be verified. Iredell County assumes no legal responsibilities for any of the information contained on this site. Users are advised that the use o
any of this information is at their own risk. All maps on this site were prepared using a 10002€TM Grid based upon the North Carolina State Plane Coordinate System
from the 1983 North American Datum. The delinquent real property tax overlay is updated monthly. The information presented is not intended to be used or relied upon
s official notice of tax liens. For additional information regardinq delinquent taxes, contact the Iredell County Tax Collector's Office.
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Project
Owner:
CATAWBA RIPARIAN BUFFER NOTIFICATION FORM
Ir eAp i I CminIN
Contractor/agent:
The approval is for the purpose and design described in your application. Impacts not indicated in the
application is a violation of the Buffer Rule. Site specific work should be provided in the application. [15A
NCAC 02H .0506 and 15A NCAC 02B .0243(8)]
Trees are not allowed to be removed from Zone 1 of the Buffer (within 30 ft of the full pond elevation), unless
approved. Exception, those trees that are severely undermined along the immediate shoreline can be
removed. Minimal shaping and sloping along the immediate shoreline is allowed. [15A NCAC 02B.0243(6)]
Benching, grading in the buffer is not allowed. Excessive disturbance of ground cover. [15A NCAC 02B .0243
(6)]
Beaches, impervious patios, impervious walkways, etc. are not allowed in the buffer unless specifically
approved by the Division. There are limitation on size for decks. [15A NCAC 02B.0243(4) and (6)]
Work to be conducted from land must indicate an access and indicate any trees that are to be removed. The
work corridor should be described. The approved access corridor shall be restored. Staging, spoil, construction
material must be outside the buffer. [15A NCAC 02H.0502 and 15A NCAC 02B.0243 (4), (6), (8)]
Stormwater cannot be piped or channeled for direct discharge to the lake. All constructed stormwater
discharges must be at the natural elevation and discharged prior to entering the buffer directed as diffuse or
sheet flow at non-erosive velocities to the lake. [15A NCAC 02B.0243(5), (6)]
Acknowledgement of Notification
I, Gk enh � nn 10 . hereby state that I have been informed of the Catawba
Riparian Buffer Rule. Any work conducted in the buffer, not specifically stated in the application and approved
by the Division of Water Resources (DWR), is a violation and subject to enforcement. Due diligence will be
taken such that the construction will be built within substantial compliance and intent of the 401 Water
Quality Certification and Buffer Rules, the approved plan(s) and specification(s), and other supporting
materials.
Signature (owner): Date: 57 W — 19

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TITLE REPORT
Dedmon Surveys
4837 NC Highway 16 North
Denvvm NC 28037
7041483/4908
This is to certify that on March 8, 2017, I made or directly supervised an accurate survey on behalf of
I Glenn & Kann Tynan situated in Mooresville - Iredell County, North Carolina, briefly
described aslot #726 of Plat Hook 40, Pg 132 and shown on 6te accompanying survey entitled:
Physical Survey -I made catefal inspection of said premises and any lmpr+ovenmts looted thereon at
flit time of the survey.
If checked, the following conditions exist on the subject property:
1. Right of ways, old highways, abandoned roads, law or driveways across said
propear
0 shown on plat
2. Easements: drainage, adlity, etc..., across said property
0 shown on plat
(x )19 drainage 8t utility easement along each property line
3. Springs, savams, rivers, ponds or lakes looted on, bordering on or running
through said property:
(x) shown on plat -
i
j 4. Cemeteries or burial grounds located on said property:
( ) shown on plat
5. Ut ty poles or overhead lines located on said property:
0 SbDWn on plat
6. Joint driveways, walkways, party walls, parches, steps, roofs or garages used in
common:
0 shown on plat
7. Enciroachments, overhanging projections6 setback violations or disputed boundaries:
( x) shown on plat
Explanation: minor 50' mbs encroachments as shown
B. Physical evidence of boundary lines:
(X) corner mark= found onset at cornets as shown on plat
() other (explain)

i
I
I
9. Is subject property improved? (x) yes 0 no
if ytes,
Building features or description: 1.5 story frame tit stucco
10. indication of new construction or repairs;
(x) No ( ) Yes ( ) Now home
() home is ander construction and foundation is 100% complete,
11. Changes or proposed changes in street lines:
(x) none visible ( ) shown on plat
13. Dcea property abut a dedicated public mad or ri&-of-way?
(x) yes, we plat () no-.pdvate nfw Ono sure
14. Is any portion of the property looted in a special flood hazard area atdetecmined
by the National Flood Insurance pmgrarn (NFM?
(x) yes Q no
If yes, we plat for details. ..
Does the home or business structare lie within a 100 year flood plain as shown on the
NRP map.
(x)yes Ono ()NIA
Professional Land Surveyor: -Nav
s
1
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PLS #t 3762

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